Yesterday, the Drug Policy Task Force met to consider THC driving limits. The DUID-marijuana working group studying the subject couldn't agree on a proposal last week, and Task Force member Senator Pat Steadman thinks its inability to do so may prevent THC-driving legislation from being blessed by the state Commission on Criminal & Juvenile Justice, under which both outfits operate. But that still might not stop a new bill.

"The subcommittee deadlocked 4-4," Steadman notes. "They reported that yesterday, and there was discussion, but really no recommendation to act on."

Steadman was unable to stay for the entire meeting, and he understands that things "got a little testy at moments" after his departure -- an indication of strongly held feelings on all sides of the issue. DUID-marijuana working group affiliates like drug counselor Laura Spicer believe strongly that the state should impose a per se standard for THC impairment, like the 5 nanograms per milliliter of blood level at the heart of a measure shelved for more study at the end of the previous legislative session. Holding a different viewpoint is working group co-chairman Sean McAllister, who believes the different effects marijuana has on individuals makes imposing a limit like the one for alcohol scientifically premature.

"I opposed the bill this past session," he says. "I was part of the majority of senators who voted to kill it on the Senate floor, and I remain rather skeptical that it's something requiring a legislative solution. I think we already have enough laws. People are already being arrested and prosecuted for this offense, and blood tests are already being taken and used as evidence. The current system seems to be working. So the only question is, should the legislature draw a bright-line standard to make prosecutors' jobs easier by legislating how much THC in the blood means impairment. And there's some doubt as to whether one size fits all."

The Cannabis Therapy Institute's Laura Kriho agrees. She's been among the most vocal critics of a THC driving standard, and she authored a letter to Task Force members outlining her objections; it's on view below.

"The consensus among experts is that there is no consensus," she maintains. "I told the commission, let's define what the problem is, so we can determine if your solution is going to cure the problem. And since there's been no increase in traffic fatalities related to THC in Colorado, I haven't seen any evidence that there is a problem."

Maybe not, but there's pressure to do something, as evidenced by this week's Denver Posteditorial, which advocated in favor of an even stricter limit than 5 nanograms. Such heat may not result in action by either the Task Force or the Commission on Criminal & Juvenile Justice, though.

"This is a very deliberative process with lots of stakeholder involvement, and we advise the CCJJ," Steadman notes. "But they have a two-thirds super-majority requirement for them to make recommendations to the legislature. And given how it's set up, I don't see this issue moving through this year -- although that remains to be seen. It moved through last year, but at this point, it may have hit a bump procedurally."

Even if the CCJJ doesn't push for a specific limit, however, Steadman stresses that another THC driving-limits bill could very well be put forward after the legislature reconvenes -- "but it won't have gone through this process to build a strong amount of consensus and buy-in."

Page down to read recommendations about THC driving limits from Michael Elliott of the Medical Marijuana Industry Group, another member of the DUID-marijuana working group. (The document can also be accessed by clicking here.) In addition, peruse the CTI letter to the Drug Policy Task Force, as well as information about an event tonight to raise money for another of Kriho's causes, the marijuana-legalization campaign known as Legalize2012.com.

The Cannabis Therapy Institute is a patient advocacy and education organization, representing thousands of patients in Colorado who are too sick to participate in the political process. This letter is in regards to your possible recommendation of THC/DUI nanogram per se limits for Colorado legal medical cannabis patients and others who drive.

NO CONSENSUS ON THC/DUI AND IMPAIRMENT As you can see from the Marijuana DUID (Per Se) Workgroup summary report, the members of this panel were not able to reach a consensus on whether impairment could be accurately correlated with a specific THC/DUI per se limit. The research shows that different people react differently to THC, and that legal medical cannabis patients and others will often have nanogram levels far above 5ng, and still be perfectly safe to drive. http://www.cannabistherapyinstitute.com/thc-dui/marijuana.duid.workgroup.summary.pdf

TARGETS INNOCENT PATIENTS A THC/DUI nanogram per se limit would unfairly target innocent cannabis patients for arrest and prosecution. Because most patients use cannabis continuously to control their conditions, they do not have the option to take their medicine later. They need to take it on schedule, just like any other medicine. Because of this continuous use, patients will often have more than 5ng of THC in their blood and still not be impaired.

For example, Westword reporter and marijuana patient William Breathes had his blood drawn to prove that a patient would be above the 5ng/mL limit even when sober. His THC blood content, after 16 hours of fasting, was 13.5 nanograms, well over the 5ng limit. Yet his physician certified that Breathes he was completely unimpaired and safe to drive. http://www.scribd.com/doc/63488115/Willam-Breathes-THC-Results

CLEARLY DEFINE PROBLEM First, it is necessary to clearly define the problem that the committee is trying to solve with the THC/DUI recommendations. CDOT statistics show that there has been no increase in accidents or fatalities related to THC in Colorado and that driving fatalities have decreased every year since 2007. See "Colorado Drugged Driving Fact Sheet" CDOT statistics show that DRE (Drug Recognition Expert) evaluators declared that 16% of the fatalities involved illegal drugs of some sort. CDOT also claims that 58% of those DRE evaluations "came up with a result of marijuana as a drug involved." However, in an Aug. 8, 2011 email to CTI, CDOT spokesperson Heather Halpape admitted that the 16% statistic does also include people whom DRE evaluators determined were under the influence of alcohol or other illegal drugs, in addition to the THC. So this statistic is also misleading because there is no way to determine whether THC was the only substance involved or whether THC actually caused the accident.

Given the fact that there is no empirical data to show that there is a THC/DUI driving "problem" in Colorado, it may very well be that there is no problem at all.

Before the DPTF recommends a solution, the committee must clearly define the problem and the metric by which "success" of the solution will be measured.

CTI EDUCATION CAMPAIGN: USE CANNABIS RESPONSIBLY: IF YOU MEDICATE, THEN WAIT Of course, the Cannabis Therapy Institute does not support or promote driving while impaired on any substance. We believe an educational campaign based on the real effects of cannabis would be of best benefit to all Colorado citizens at this point, until the research proves there is a clear problem and that the THC/DUI per se limit is the only solution to the "problem".

CTI has started a THC/DUI educational campaign based on facts about cannabis effects on driving and the realities of Colorado's marijuana laws, stressing the importance of personal responsibility and knowledge of how cannabis affects you.

The CTI THC/DUI educational campaign is based on the FDA's warning on Marinol (a synthetic form of THC prescribed in pill form). The caution statement on Marinol reads: "Patients receiving treatment with Marinol capsules should be specifically warned not to drive, operate machinery, or engage in any hazardous activity until it is established that they are able to tolerate the drug and to perform such tasks safely." http://www.drugs.com/pro/marinol.html

The federal government believes patients using THC-therapy are safe to drive, as long as they are cautious about how the medicine may affect them. Why then would Colorado adopt a standard that anyone with THC in their bloodstream was impaired? Instead of an outright prohibition on driving, the FDA gives rational, adult advice to patients to wait and see how cannabis affects them before they drive. The FDA recognizes that most patients will be able to drive safely after ingesting cannabis and expects patients to exercise personal responsibility and common sense to determine their own impairment.

The CTI THC/DUI awareness campaign can be summed up with these phrases, "Use cannabis responsibly. If you medicate, then wait." The length of time a patient will have to wait after they medicate depends on many factors. But once a patient get used to the effects of THC, they are likely to be able to drive safely.

CDOT "DRUGGED DRIVING" CAMPAIGN The Colorado Department of Transportation (CDOT) announced its new Drugged Driving Campaign on Aug. 14. While it is commendable for CDOT to try to educate patients about cannabis use and driving, CTI believes the campaign is designed to frighten and demonize patients while falling far short of providing any meaningful education about the effects of cannabis.

The message behind the CDOT Drugged Driving Campaign is that the legal consequences of driving under the influence of cannabis are the same as the legal consequences of driving under the influence of alcohol. This is true and useful information for patients. However, the usefulness of the campaign seems to stop there.

The CDOT message is that it's "not safe to medicate and drive." Clearly, thousands of patients in Colorado know that this is not true and have been driving safely for years. Many patients feel targeted and disrespected because of discriminatory campaigns like this.

TRUE EFFECTS OF THC ON DRIVING Most cannabis experts agree that THC, as only one of the active ingredients in cannabis, can cause side effects that may affect driving in some people, including drowsiness, decreased reaction time, and distraction. However, the truth is that these side effects are minor, and most patients can compensate for them and drive safely.

TIME OF ONSET AND DURATION The most important educational information for cannabis consumers is what the side effects of cannabis are, the time of onset of these side effects, and how long they might last.

Some examples of cannabis onset and duration charts can be found in the Erowid Vaults under Cannabis Effects: http://www.erowid.org/plants/cannabis/cannabis_effects.shtml

The Erowid charts show that the onset of the effects of smoked cannabis usually occur within 10 minutes of smoking, peak in 15 to 30 minutes, and have a total duration of 1 to 4 hours.

For consumed cannabis (edibles), the onset of effects can take up to 2 hours, peak in 2 to 5 hours, and have a total duration of 4 to 10 hours.

The Erowid page also contains a very important statement: "Caution: Reactions and experiences may vary dramatically from person to person."

So, once again, the FDA advice is the most appropriate: Wait until you see how it affects you and you are certain you can drive safely.

SUMMARY The scientific evidence linking a specific THC per se limit to impairment in all people does not exist. The evidence gathered by the Marijuana DUID Workgroup confirms this, as does all the evidence given in the testimony on HB 11-1261 in the state legislature. A THC per se limit discriminates against legal medical cannabis patients who will quite often be above a 5 ng limit in their blood because of their chronic use, but not be impaired at all.

CTI RECOMMENDATIONS 1) Define the problem clearly and the metric by which the success of the solution will be measured. 2) Do not institute a DUI per se limit that will cause innocent patients to be prosecuted. 3) Recommend funding for an educational campaign based on facts, not fear, to show patients how to recognize the effects of cannabis, how long cannabis may take to produce the effects, and how long those effects might last. 4) The medical cannabis industry should not adopt the blanket advice to their patients to never medicate and drive. Rather, medical cannabis patients should be specifically cautioned not to drive, operate machinery, or engage in any hazardous activity until it is established that they are able to tolerate the drug and to perform such tasks safely.

The advice to patients should be to "Use Cannabis Responsibly: If you medicate, then wait." Since all patients are different, and the methods of ingestion have various onset times, the amount of time a patient will have to wait will vary and will be determined by the patient responsibly.

Educational campaigns based on fact will be more helpful to our Colorado citizens than a blanket attempt to prosecute anyone with THC in their blood, regardless of real impairment.

By definition, in Colorado, medical cannabis patients have debilitating medical conditions and are very sick with chronic or terminal illnesses. Colorado citizens enacted our medical marijuana law out of compassion for patients and wanted to allow patients to use cannabis safely without fear of discrimination. A THC/DUI per se limit would unfairly target a large group of Colorado citizens based only on the fact that they chose marijuana over other prescription drugs, which have no per se limit. Please recognize the compassionate need for medical marijuana patients to be free from discrimination and allow them to use their medicine of choice in a safe and responsible manner. Let's treat Colorado cannabis patients like responsible adults and not assume that they cannot drive safely just because of a random number with no scientific or rational basis.

Thank you for your sincere attention to this matter. Please let me know if you have any questions.